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9781405148573_1_pre.qxd 5/13/10 16:07 Page i

Cardiovascular Critical Care

Cardiovascular Critical Care Edited by Mark J.D. Griffiths, Jeremy J. Cordingley and Susanna Price
© 2010 Blackwell Publishing Ltd. ISBN: 978-1-405-14857-3
9781405148573_1_pre.qxd 5/13/10 16:07 Page iii

To our teachers and colleagues, many of whom are

contributors to this book.
9781405148573_1_pre.qxd 5/13/10 16:07 Page v

Cardiovascular
Critical Care
EDITED BY

Mark J.D. Griffiths MRCP PhD EDICM BDICM

Consultant in Intensive Care Medicine
Royal Brompton & Harefield NHS Foundation Trust
London, UK

Jeremy J. Cordingley MRCP FRCA EDICM

Consultant in Intensive Care Medicine and Anaesthesia
Royal Brompton & Harefield NHS Foundation Trust
London, UK

Susanna Price MRCP PhD EDICM FESC

Consultant in Intensive Care Medicine and Cardiology
Royal Brompton & Harefield NHS Foundation Trust
London, UK

A John Wiley & Sons, Inc., Publication

9781405148573_1_pre.qxd 5/13/10 16:07 Page vi

This edition first published 2010, © 2010 by Blackwell Publishing Ltd

BMJ Books is an imprint of BMJ Publishing Group Limited, used under licence by Blackwell
Publishing which was acquired by John Wiley & Sons in February 2007. Blackwell’s publishing
programme has been merged with Wiley’s global Scientific, Technical and Medical business to
form Wiley-Blackwell.
Registered office: John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex,
PO19 8SQ, UK
Editorial offices: 9600 Garsington Road, Oxford, OX4 2DQ, UK
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For details of our global editorial offices, for customer services and for information about how to
apply for permission to reuse the copyright material in this book please see our website at
www.wiley.com/wiley-blackwell
The right of the author to be identified as the author of this work has been asserted in accordance
with the Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or
transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or
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damages arising herefrom.
Library of Congress Cataloging-in-Publication Data
Cardiovascular critical care / edited by Mark J.D. Griffiths . . . [et al.].
p. ; cm.
Includes bibliographical references.
ISBN 978-1-4051-4857-3
1. Cardiac intensive care. I. Griffiths, M. J. D.
[DNLM: 1. Cardiovascular Diseases. 2. Critical Care. WG 120 C26716 2010]
RC684.C36C377 2010
616.1′2028 – dc22
2009029876
ISBN: 978-1-4051-4857-3
A catalogue record for this book is available from the British Library.
Set in 9.25/11.5pt Minion by Graphicraft Limited, Hong Kong
Printed in Singapore
1 2010
9781405148573_1_pre.qxd 5/13/10 16:07 Page vii

Contents

Contributors, ix
Introduction, xiii
Chapter 1 Shock, 1
Marius Terblanche and Nicole Assmann
Chapter 2 Resuscitation in Intensive Care, 22
David A. Zideman
Chapter 3 Cardiovascular Monitoring in Critical Care, 42
Michael R. Pinsky
Chapter 4 Cardiovascular Investigation of the Critically Ill, 62
Susanna Price and Jeremy J. Cordingley
Chapter 5 Haematological Aspects of Cardiovascular
Critical Care, 83
Kanchan Rege and Mark J.D. Griffiths
Chapter 6 Cardiovascular Support: Pharmacological, 100
Joseph E. Arrowsmith and Florian Falter
Chapter 7 Arrhythmias, 120
Hugh Montgomery and Vivek Sivaraman
Chapter 8 Mechanical Heart Failure Therapy, 139
Richard Trimlett
Chapter 9 Care of the High Risk Patient Undergoing Surgery, 154
Justin Woods and Andrew Rhodes

Chapter 10 Adult Congenital Heart Disease: Principles of

Management in Critical Care, 167
Susanna Price and Brian Keogh
Chapter 11 Common Complications of Cardiovascular
Critical Illness, 193
Simon J. Finney and Mark J.D. Griffiths
Chapter 12 Haemodynamic Management of Severe Sepsis, 218
Jean-Louis Vincent

Chapter 13 Acute Coronary Syndromes and Myocardial Infarction, 234

Alex Hobson and Nick Curzen

vii
9781405148573_1_pre.qxd 5/13/10 16:07 Page viii

viii Contents

Chapter 14 Cardiogenic Shock, 256

Divaka Perera and Gerald S. Carr-White
Chapter 15 Peri-operative Care of the Heart Transplant Recipient, 279
Keith McNeil and John Dunning
Chapter 16 Adult Congenital Heart Disease Syndromes, 290
Antonia Pijuan Domènech, Katerina Chamaidi and Michael A. Gatzoulis
Chapter 17 Management of Arrhythmias in Adults with Congenital
Heart Disease, 303
Barbara J. Deal
Chapter 18 Mitral Valve Disease, 315
Susanna Price and Derek Gibson
Chapter 19 Aortic Valve Disease, 329
Susanna Price and Derek Gibson
Chapter 20 Infective Endocarditis, 347
David Hunter and John Pepper
Chapter 21 Pulmonary Hypertension and Right
Ventricular Failure, 367
Alain Vuylsteke
Chapter 22 Aortic Dissection, 383
Maninder S. Kalkat, Vamsidhar B. Dronavalli, David Alexander
and Robert S. Bonser
Chapter 23 Emergency Management of Cardiac Trauma, 401
James Napier and Mark Messent
Chapter 24 Hypertensive Crises, 413
Liao Pinhu and Mark J.D. Griffiths
Chapter 25 Pregnancy, 424
Lorna Swan
Chapter 26 Vasculitis, 434
Lorna Swan
Chapter 27 Endocrine Problems and Cardiovascular Critical Care, 442
Phil Marino and Susanna Price
Chapter 28 Haemodynamic Monitoring and Therapy: A Personal
History 1961–1994, 454
Ronald Bradley
Index, 465
The colour plate section can be found facing p. 82
9781405148573_1_pre.qxd 5/13/10 16:07 Page ix

Contributors

David Alexander MBChB, FRCA

Consultant Anaesthetist, Department of Anaesthesia and Critical Care,
Royal Brompton & Harefield NHS Foundation Trust, London, UK
Joseph E. Arrowsmith MB BS, MD, FRCP, FRCA, FHEA
Consultant in Cardiothoracic Anaesthesia & Intensive Care, Papworth
Hospital, Cambridge, UK
Nicole Assmann MD, FRCA
Consultant Anaesthetist, Royal Free Hospital, London, UK
Robert S. Bonser MD, FRCP (Lon), FRCS (Eng), FRCS (C/Th), FESC
Consultant Cardiothoracic Surgeon, University Hospital Birmingham
NHS Trust, Birmigham, UK
Ronald Bradley FRCP
Emeritus Professor, Intensive Care Medicine, St Thomas’ Hospital,
London, UK
Gerald S. Carr-White MD
Department of Cardiology, Guys’ and St Thomas’ NHS Foundation
Trust, London, UK
Katerina Chamaidi MD
Adult Congenital Heart Centre and Centre for Pulmonary Hypertension,
Royal Brompton & Harefield NHS Foundation Trust, London, UK and
General Hospital of Trikala, Greece
Nick Curzen PhD, FRCP, FESC
Wessex Cardiac Unit, Southampton University Hospitals NHS Trust,
Southampton, UK and Southampton University Medical School,
Southampton, UK
Barbara J. Deal MD
M.E. Wodika Professor of Cardiology, Feinberg School of Medicine,
Northwestern University, Children’s Memorial Hospital, Chicago,
IL, USA
Antonia Pijuan Domènech MD
Adult Congenital Heart Centre and Centre for Pulmonary Hypertension,
Royal Brompton & Harefield NHS Foundation Trust, London, UK and
Adult Congenital Heart Disease Unit, Hospital Vall d’Hebron, Barcelona,
Spain, UK

ix
9781405148573_1_pre.qxd 5/13/10 16:07 Page x

x Contributors

Vamsidhar B. Dronavalli MRCS (Edin)

Research Fellow Cardiothoracic Surgery, Department of Cardiothoracic
Surgery, University Hospital Birmingham NHS Trust, Birmingham, UK

John Dunning MD
Papworth Hospital, Cambridge, UK

Florian Falter MD, FRCA, PhD

Consultant in Cardiothoracic Anaesthesia & Intensive Care, Department
of Anaesthesia, Papworth Hospital, Cambridge, UK

Simon J. Finney PhD, MSc, MRCP, FRCA

Consultant in Intensive Care and Anaesthesia, Adult Intensive Care Unit,
Royal Brompton & Harefield NHS Foundation Trust, London, UK

Michael Gatzoulis MD
Adult Congenital Heart Centre and Centre for Pulmonary Hypertension,
Royal Brompton & Harefield NHS Foundation Trust, London, UK and
National Heart & Lung Institute, Imperial College, London, UK

Derek Gibson MD
Department of Cardiology, Royal Brompton & Harefield NHS Foundation
Trust, London, UK
Alex Hobson PhD, FRCP, FESC
Wessex Cardiac Unit, Southampton University Hospitals NHS Trust,
Southampton, UK and Southampton University Medical School,
Southampton, UK
David Hunter MD, MBBS, FRCA
Consultant Anaesthetist & Intensivist, Anaesthetic Department, Royal
Brompton & Harefield NHS Foundation Trust, London, UK
Maninder S. Kalkat FRCS (Cardiothoracic)
Consultant Cardiothoracic Surgeon, Department of Cardiothoracic
Surgery, Birmingham Heartlands Hospital, Birmingham, UK
Brian Keogh MD
Consultant Anaesthetist and Intensivist, Department of Intensive Care and
Anaesthesia, Royal Brompton & Harefield NHS Foundation Trust,
London, UK
Philip Marino BSc (Hons), MRCP (UK)
Specialist Registrar in Respiratory & Intensive Care Medicine, Kingston
Hospital, Kingston-upon-Thames, UK
Keith McNeil MB, BS, FRACP
Head of Transplant Services, The Prince Charles Hospital, Brisbane,
Australia
Mark Messent MD
Consultant Anaesthetist & Intensivist, Intensive Care Unit, St
Bartholomew’s Hospital, London, UK
9781405148573_1_pre.qxd 5/13/10 16:07 Page xi

Contributors xi

Hugh Montgomery MB BS, BSc, FRCP, MD

Director, Institute for Human Health and Performance, University
College London, London, UK

James Napier MBChB, FRCS, FCEM, EDICM

Intensive Care Unit, St Bartholomew’s Hospital, London, UK

John Pepper M.Chir, FRCS

Professor of Cardiothoracic Surgery, Department of Surgery, Royal
Brompton & Harefield NHS Foundation Trust, London, UK

Divaka Perera MD
Department of Cardiology, Guys’ and St Thomas’ NHS Foundation Trust,
London, UK

Liao Pinhu MD, PhD

Unit of Critical Care, National Heart and Lung Institute, Imperial
College London, London, UK and Youjiang Medical University for
Nationalities, Baise, PR, China

Michael R. Pinksy MD, CM, DM, MC

Professor of Critical Care Medicine, Department of Critical Care
Medicine, Bioengineering and Anesthesiology, Univerity of Pittsburgh
School of Medicine, Pittsburgh, PA, USA

Kanchan Rege MA, MRCP, FRCPath

Consultant Haematologist, Papworth Hospital, Cambridge, UK

Andrew Rhodes MD
Consultant in Intensive Care Medicine, Department of Anaesthesia and
Intensive Care Medicine, St George’s Hospital, London, UK

Vivek Sivaraman MBBS, MRCP, MD

Specialty Trainee, Anaesthetics and Critical Care, Central London School
of Anaesthesia, London, UK

Lorna Swan MB ChB, MRCP, MD

Consultant Cardiologist, Adult Congenital Heart Disease Unit, Royal
Brompton & Harefield NHS Foundation Trust, London, UK

Marius Terblanche MBChB, FRCA, EDIC, Dip(Epid)

Consultant in Critical Care Medicine, Guy’s & St Thomas’ Hospital,
London, UK

Richard Trimlett MD
Consultant Cardiac Surgeon, Royal Brompton & Harefield NHS
Foundation Trust, London, UK

Jean-Louis Vincent MD, PhD

Professor of Intensive Care Medicine;
Head, Department of Intensive Care, Erasme University Hospital,
University of Brussels, Belgium
9781405148573_1_pre.qxd 5/13/10 16:07 Page xii

xii Contributors

Alain Vuylsteke MD, FRCA

Consultant Anaesthesia and Intensive Care, Royal Brompton
& Harefield NHS Foundation Trust, London and Cardiothoracic
Anaesthesia and Intensive Care, Papworth Hospital, Cambridge, UK

Justin Woods FRCA

Clinical Research Fellow in Intensive Care Medicine, Department of
Anaesthesia and Intensive Care Medicine, St George’s Hospital,
London, UK
David A. Zideman MD
Chief of Service, Department of Anaesthetics, Imperial College Healthcare
NHS Trust and Hammersmith Hospital, London, UK
9781405148573_1_pre.qxd 5/13/10 16:07 Page xiii

Introduction

More than 850,000 people in the United Kingdom suffer from heart failure,
at a cost to the NHS of an estimated £625 million per year. Approximately
2.65 million people have coronary artery disease, accounting for 13% of all
deaths in England, many of them premature. It has been calculated that the
cost of heart disease in the UK today is over £7 billion, a sum that includes
the financial burden of informal care provided by more than 400,000
families and friends. Cardiac pathology is also no respecter of age. Thus, the
increasing success of surgery provided to children born with heart defects in
the 1980s and 1990s has delivered a generation of young adults who require
on-going monitoring and treatment. There are approximately 250,000 such
adults in the UK.
The burden of disease is therefore significant. The common thread that
binds together individuals who suffer from these conditions is both the
adverse quality of life that it brings, and the need to design, validate and
apply effective therapeutic interventions to extend both life and quality of
life. The successes in this area have been legion and include
cardiopulmonary bypass surgery, conducted successfully for the first time
only in the 1950s; a large and increasing variety of percutaneous
interventions both for coronary artery disease and valvular pathologies; the
management of arrhythmias both malignant and benign; and novel
cardiopulmonary support systems up to and including ventricular assist
devices and extracorporeal membrane oxygenation. The development and
application of these support systems and therapeutic interventions
necessitates the provision of intensive care of the highest quality.
On the Department of Health’s Census Day (15 January 2008), there
were 3473 Level 2 and Level 3 intensive care unit (ICU) beds occupied in
NHS Trusts in England. Sixteen percent (552) of these beds were in
cardiothoracic units, although it is almost certain that significant numbers
of patients not requiring surgical interventions, but with cardiovascular
pathologies, were being cared for in general intensive care or high
dependency areas. In certain respects, cardiovascular ICU might be
regarded as routine. Thus, for the year ending March 2007, 35,487 cardiac
operations were performed with a 96.6% survival rate in over 40 centres in
the UK as a whole [1]. These remarkable survival results, comparable to
those achieved by the best healthcare systems across the world, are a
reflection of the skill not only of surgical and anaesthetic practitioners but
also of those involved in the provision of intensive care.
Rapid advances in research and clinical practice in this arena mandate
the development of first-rate educational resources for those involved in

xiii
9781405148573_1_pre.qxd 5/13/10 16:07 Page xiv

xiv Introduction

clinical practice. I am delighted therefore to be able to introduce this

volume, edited by three of my colleagues, which provides a superb overview
of contemporary cardiovascular critical care. The clinical field involved is
broad. Effective pre-operative assessment of patients by intensivists is a skill
that all should possess. A working knowledge of the haematological
complications of cardiovascular surgery and critical care is mandatory.
Care of the medical patient with ischaemic heart disease or in acute
cardiogenic shock has progressed in leaps and bounds, and now spills over
into the use of adjunct support such as non-invasive respiratory support
[2]. The particular problems associated with the management of the patient
with adult congenital heart disease are recognised in this volume, together
with those consequent upon pregnancy, eclampsia and the hypertensive
crisis. Mark Griffiths and colleagues have recruited authors with recognised
expertise in their subject, who together have produced a volume that should
assist greatly those practising in cardiovascular critical care to the benefit of
their patients.

References
1. UK Healthcare Commission statistics, 2008.
2. New Engl J Med 2008; 259: 142–51.

Timothy W. Evans DSc FRCP FRCA FMedSci

Professor of Intensive Care Medicine, Imperial College School of Medicine;
Consultant in Intensive Care Medicine, Royal Brompton Hospital, London
9781405148573_5_plate.qxd 5/13/10 16:22 Page 1

Plate 4.1a Tissue velocity mapping demonstrating inter-ventricular dyssynchrony (trans-

thoracic echocardiography). Left of the image shows the 2D representation of the heart
(lower) and TVI mapping (upper) with sample volumes placed at the annulus of the right
ventricle (green) and free wall of the left ventricle (yellow). Right of the image, the
corresponding tissue velocities sampled are shown (x axis time in seconds, y axis velocity in
centimetres per second) for the right ventricle (arrowed, a) and the left ventricle (arrowed, b).

PPEP APEP

ECG

Plate 4.1b Corresponding ejection from the right and left heart resulting from the
dyssynchrony shown in Figure 4.4a. Here, a difference in pre-ejection period between the
right heart (pulmonary pre-ejection period, PPEP) and left heart (aortic pre-ejection period,
APEP) of > 40 msec is shown, resulting from inter-ventricular dyssynchrony. ECG
Electrocardiogram.

Cardiovascular Critical Care Edited by Mark J.D. Griffiths, Jeremy J. Cordingley and Susanna Price
© 2010 Blackwell Publishing Ltd. ISBN: 978-1-405-14857-3
9781405148573_5_plate.qxd 5/13/10 16:22 Page 2

(a) (b)

A A
P P
LA LA
RA RA

LV RV
RV LV

Plate 10.1 Variants of transposition. (a) Transposition of the great arteries, with normal
atrio-ventricular connections but discordant ventriculo-atrial connections. (b) Congenitally
corrected transposition of the great arteries, with discordant atrio-ventricular and
ventriculo-atrial connections. RA, right atrium; RV, right ventricle; LA, left atrium; LV, left
ventricle; A, aorta; P, pulmonary artery.

(a) (b) (c)

AO
PA AO

LA PA

RA

LV
RV

Plate 10.2 Examples of systemic-pulmonary shunts. (a) Pulmonary atresia plus VSD – here,
pulmonary blood flow is via a patent ductus arteriosus. (b) Pulmonary atresia with blood
supply to confluent pulmonary arteries from sytemic-pulmonary collaterals. (c) Common
arterial trunk, where there is a common valve and arterial trunk from the ventricles, giving rise
to the left and right pulmonary arteries from the ascending aorta. RA, right atrium; RV, right
ventricle; LA, left atrium; LV, left ventricle; PA, pulmonary artery; AO, aorta.
9781405148573_5_plate.qxd 5/13/10 16:22 Page 3

(a) SVC (b) SVC

RPA LPA PA

RA RA

IVC IVC

(c) (d) SVC

PA
PA

RA RA

IVC IVC

Plate 10.3 Different types of venous anastamosis used in patients with absent or deficient
right-sided connections. (a) Classical Glenn. (b) Bidirectional Glenn. (c) Atrio-pulmonary
Fontan. (d) Total cavo-pulmonary connection (TCPC) – lateral tunnel. RA, right atrium;
IVC, inferior vena cava; RPA, right pulmonary artery; LPA, left pulmonary artery; SVC, superior
vena cava.

Absent superior rim

Aortic

ASD

Large infero-posterior rim

Plate 10.4 Three-dimensional TOE of a large secundum atrial septal defect (ASD) in a
patient prior to surgical closure. The image is taken from the left atrium, looking through the
ASD into the right atrium.
9781405148573_5_plate.qxd 5/13/10 16:22 Page 4

Aortic

LAVV RAVV

ECG

Plate 10.5 Three-dimensional TOE of a patient with an unoperated incomplete atrio-

ventricular septal defect (AVSD). The image is shown from the roof of the atria, looking down
on the two separate orifices of the atrio-ventricular valves during diastole. Note the absence
of inter-atrial septum and abnormal anatomical arrangement of the aortic valve with respect
to the atrio-ventricular valves. LAVV left atrio-ventricular valve, RAVV right atrio-ventricular
valve, Aortic aortic valve, ECG electrocardiogram.

Overriding
aorta

Hypoplastic
pulmonary
trunk
Infundibular
stenosis RA Ventricular
septal defect
LV
RV

Hypertrophied
right ventricle

Plate 10.6 Unoperated tetralogy of Fallot, with the various components marked.
In addition to the classical four components, there are frequently abnormalities of the
pulmonary valve and/or pulmonary trunk (as shown). RA, right atrium; RV, right ventricle;
LV, left ventricle.
9781405148573_5_plate.qxd 5/13/10 16:22 Page 5

ECG

Plate 16.1 Doppler continuous wave (CW) sample in the area of coarctation, showing a
peak velocity at the excess of 4 m/sec (pressure gradient more than 64 mmHg) and increased
velocity throughout systole and diastole (diastolic tail), both indicative of significant,
severe coarctation.

Plate 18.1 Continuous wave Doppler of tricuspid regurgitation demonstrating a peak

velocity of 2.9 m/sec (pressure drop 34 mmHg).
9781405148573_5_plate.qxd 5/13/10 16:22 Page 6

a b

ECG

Plate 18.2 TOE demonstrating severe paraprosthetic regurgitation. In the left side of the
figure (a) outline of the valve leaflets (inner circle) and sewing ring (outer circle) are
highlighted. Arrow indicates the space between the sewing ring and annulus. In the right side
of the figure (b) colour Doppler demonstrates flow between the sewing ring and annulus in
systole (arrowed).

LA

AV

RVOT

ECG

Plate 19.1 M-mode trans-oesophageal echocardiography (mid-oesophageal, left

ventricular outflow tract view) in a patient with severe aortic valve endocarditis. Here, the
colour jet represents blood flow back into the left ventricle during diastole (arrowed), and is
10 mm in depth, representing severe aortic regurgitation. For reference, a two-dimensional
picture is shown at the top of the image. LA left atrium, AV aortic valve, RVOT right
ventricular outflow tract, ECG electrocardiogram.
9781405148573_5_plate.qxd 5/13/10 16:22 Page 7

LA

Abscess

AV
Ao

RVOT

ECG

Plate 19.2 Two-dimensional trans-oesophageal echocardiography (mid-oesophageal, left

ventricular outflow tract view) in a patient with previous St Jude aortic valve replacement and
an aortic root abscess. Note the small paraprosthetic jet (arrowed in the figure on the right)
and the absence of vegetations on the valve. At operation the abscess was found to extend to
the level of the pulmonary artery bifurcation, providing the only continuity between the
ascending aorta above this level and the aortic root. LA left atrium, AV aortic valve, Ao
ascending aorta, RVOT right ventricular outflow tract, ECG electrocardiogram.

LV

AV

ECG

Plate 19.3 Two-dimensional trans-oesophageal echocardiography (trans-gastric left

ventricular outflow tract view) in a patient with bicuspid aortic valve and sub-aortic stenosis
(arrowed). In the figure on the right, colour Doppler reveals flow acceleration and aliasing of
the colour jet, indicating high velocity blood flow due to the sub-aortic membrane. LV left
ventricle, AV aortic valve, ECG electrocardiogram.
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were paid for his ransom. Scanderbeg now made a razzia on a large
scale into Macedonia and returned laden with an immense booty of
every description. His fame was so solidly established by these
victories that the republic of Venice sent a magnificent embassy to
compliment him and convey to him the news of his appointment as
governor-general of all the Italian possessions along the Adriatic and
in the interior, where the important cities of Scutari and Alessio were
situated. His name was enrolled in the Golden Book at the head of
the list of Venetian nobles.
The revolt of the Janizaries having obliged Amurath to leave his
luxurious retreat at Magnesia and once more resume the
management of public affairs, he determined to conduct in person
the war against Scanderbeg. He soon appeared at the head of a
formidable army before Sfetigrad, which surrendered after a gallant
resistance. During the siege the Turks lost in one of the assaults six
thousand men. Satisfied, apparently, with this single victory, the
slothful sultan retired into Macedonia after leaving a strong garrison
in the captured fortress. Scanderbeg hovered on his flanks and rear,
making many prisoners and taking a large amount of stores and war
material; then, after seeing him well out of the country, he turned
towards Sfetigrad and sat down before it on September 20, 1445,
with eighteen thousand men, among whom were adventurers from
almost every country in Europe, Germans, French, and Italians being
the most numerous. For want of artillery no regular siege could be
conducted, and Scanderbeg was repulsed with heavy loss in his
attacks on the place. Hearing that Amurath was preparing to return,
he hastily concentrated his available troops around Croia, which was
provisioned for a long resistance. Some large, unwieldy pieces of
cannon, directed by Frenchmen, added to the strength of the capital.
The sultan was slow in his movements, and did not appear as soon
as was expected. In the meanwhile Scanderbeg was encouraged by
receiving congratulatory letters from Pope Nicholas V., which were
brought to him by two Franciscans, one of whom was a bishop. The
winter of 1449-50 had been passed by him in the saddle inspecting
every fortress, going into every part of his dominions to encourage
the people and hasten the levy of troops. The coming tempest was
naturally expected to assail the capital; and to make its
neighborhood a howling wilderness, the whole country around Croia
was ravaged by his order, for a distance of from fifteen to eighteen
miles, so completely that not a house or a bridge was left standing,
and not a road passable; every growing and living thing was either
destroyed or removed. The enemy could find no shelter there.
On April 15, 1450, the sultan appeared before the city with an army
of one hundred and sixty thousand fighting men and a host of camp-
followers. Uranocontes commanded inside and repelled numerous
assaults, while Scanderbeg, with a force of five thousand picked
cavalry, hovered about the outskirts of the enemy, inflicting
considerable loss in men and stores, but above all annoying the long
line of communications by which the army drew its daily supplies.
Amurath finally tired of the siege, and, being convinced that the
mountains and valleys of Epirus were not worth his time, his trouble,
or his money while richer conquests awaited him, charged a certain
Yousouf to leave the camp and seek Scanderbeg, to try and induce
him to accept the single condition of an annual tribute of only ten
thousand ducats. After a two days’ search he was found, but
instantly rejected even this almost nominal condition attached to the
independence of his country. Knowing that he could not take Croia
by assault or maintain his army any longer in such a country, the
sultan slowly retreated and died soon afterwards at Adrianople, on
February 5, 1451. He was succeeded by his son, Mohammed II.,
who renewed his father’s offer, but with no better result.
The news of Amurath’s ill-success before Croia made a great noise in
Italy, and even beyond. The kings of Hungary and Aragon, and
Philip, Duke of Burgundy, sent complimentary missions to the
Albanian hero, and presents of money and provisions. King
Alphonsus of Aragon, who was also King of Sicily and Naples, sent
him four hundred thousand bushels of grain. Among other rich
presents that he received from this magnificent monarch was a
helmet or casque of the finest Spanish steel, lined on the inside with
Cordovan leather and soft silk, and covered on the outside with the
purest gold artistically chased and embossed by an Italian jeweller
and studded with precious stones. Scanderbeg was very proud of
this really regal headgear, and ranked it along with his famous
sword, a veritable Excalibur, the blade of which was of perfect
Damascus workmanship, and the handle a blaze of Oriental gems
set with exquisite skill by a Persian lapidary. This weapon was a
present from Amurath on giving him his first command. With it he
killed at least two thousand Turks in his war of independence, and it
was looked upon by his enemies with a species of superstitious awe.
During one of the informal truces between the Turks and Christians
Sultan Mohammed begged to see the blade of which he had heard
so much. It was sent to him and tried by the best swordsmen of his
army, but not one of them could perform the feats that its owner
had been seen to do with it; and when it was returned, the sultan
told him this and asked the reason. “I sent your highness the
sword,” said Scanderbeg, “but not the limb that wields it!” When he
went into battle, it was always with his right arm bare and his
shoulder perfectly free. He was so tall and strong that a few years
later, when he went over to Italy to assist King Ferdinand, and had
occasion to meet the commander of the enemy’s troops—the famous
condottiére Count Piccinino, whose stature, it is true, was small, but
still that of a grown person—he took him by the belt with one hand,
and, slowly raising him up, impressed a courtly kiss upon the
forehead and as gently set him down again. He looked so brave and
handsome that even his foes applauded.
 “His haughtie helmet, horrid all with gold,
Both glorious brightnesse and great terrour bredd:
For all the crest a dragon did enfold
With greedie pawes, and over all did spredd
His golden winges; his dreadfull hideous hedd,

Close couchèd on the bever, seemed to throw

From flaming mouth bright sparcles fiery redd,
That suddeine horrour to faint hartes did show;
And scaly tayle was stretcht adowne his back full low.”
—Spenser.

In May, 1451, Scanderbeg married the Princess Donica, daughter of

Arrianites Thopia, one of the most influential lords of Albania, and
connected on his mother’s side with the imperial family of the
Comneni. He received at this time from King Alphonsus five hundred
arquebusiers, the same number of expert crossbow-men, and a few
pieces of artillery with their cannoniers. We have only space to
mention the events of the next years: how successive armies of
Turks were defeated; how Scanderbeg himself was repulsed with a
loss of five thousand men in an attack on Belgrade; and how, during
a lull in the war, he was invited over to Italy by Pope Pius II. to the
assistance of King Ferdinand, son of his old friend Alphonsus, who
was hard pressed by his rival, John of Anjou. (Raynald. Annales Eccl.
ad an. 1460, num. lx.) He contributed greatly to the victory won at
Troja on Aug. 18, 1462, and for his services was created Duke of
San Pietro, in the kingdom of Naples. He remained in Italy a little
over a year. Recalled to Albania by the appearance of the Turks, he
repulsed Sultan Mohammed from Croia; but his own losses and the
new plans of the enemy, which consisted in sending only small
armies under experienced generals—one of whom, Balaban Badera,
was an Albanian renegade—with orders to avoid battle if possible,
but to remain in the country at all hazards, made him feel that his
cause was failing, and that, unless relieved from the west, he must
sooner or later succumb. In this emergency he went to Rome and
appealed to the pope and cardinals to preach a new crusade. The
example of the broken-hearted Pius II. showed how fruitless it
would have been for them to do so. Paul, indeed, wrote to all the
Christian princes, but he got nothing but fair words in return. The
great schism had lamentably diminished the prestige of the Papacy,
and a multitude of heretics more or less openly preluded that
Reformation which would soon divide Christendom itself into hostile
camps. The pope gave him three thousand golden florins and
conferred upon him the insignia of the cap and sword which is
annually blessed by the pontiff on the vigil of Christmas for
presentation to the prince who has deserved best of the church.
Scanderbeg lodged while in Rome in a house which, although rebuilt
in 1843, still retains over the door his portrait in fresco and the
laudatory inscription set up soon after his death. The street and an
adjoining little piazza under the Quirinal gardens have long
perpetuated his name as the Via di Scanderbeg. He left Rome in
disappointment and sorrow.
“Ah! what though no succor advances,
Nor Christendom’s chivalrous lances
Are stretched in our aid? Be the combat our own!
And we’ll perish or conquer more proudly alone;
For we’ve sworn by our country’s assaulters,
By the virgins they’ve dragged from our altars,
By our massacred patriots, our children in chains,
By our heroes of old, and their blood in our veins,
That, living, we shall be victorious,
Or that, dying, our deaths shall be glorious.”
—Campbell.

On his way back to Albania he was allowed to recruit in the Venetian

territories a force of thirteen thousand men, which he commanded in
person. His former little army in the field was captained by his
faithful friend Tanusios, and after planning together the two generals
attacked the Turks around Croia on two different points, while a
vigorous sortie was made by the besieged, during which Balaban,
the Turkish commander, was killed. His death and the suddenness
and vigor of the triple attack threw the enemy into confusion, and
they were completely routed. We pass over other battles and
victories, by which Scanderbeg’s resources were finally exhausted.
The end had come. During the winter of 1466-7 he was making a
tour of inspection, and while in the city of Alessio, or Lissa, as it is
sometimes called, where the ambassador of Venice and the
confederate chiefs of Albania had convened to meet him and
combine for one last and desperate effort, he was seized by a fever
which proved fatal. After addressing a solemn and pathetic discourse
to his principal officers, he embraced them one by one, and gave
orders to his only son John to cross over to his Neapolitan fiefs with
his mother, and there wait until some favorable occasion might
present itself to return and put himself at the head of his
countrymen as his father had done. He died during the night of
January 17, 1467, after having received the Viaticum and Extreme
Unction, and was buried in the cathedral church of Alessio. His death
caused a profound sensation throughout Europe. Mohammed
exulted over the loss of one whom he called the sword and buckler
of the Christians, and immediately poured his troops into Albania;
but it was not until the year 1478, when Croia surrendered on
conditions which were afterwards basely violated, that the war
ended. Since that time the infamous Turks have lorded it over the
land made glorious in legendary lore by the son of Achilles, in history
by King Pyrrhus, and in modern times by Scanderbeg. The presence
of those barbarous Asiatics in any part of Europe is one of the
foulest stains upon the moral sense and the politics of Christian
governments.
When Alessio was captured the infidels dug up the remains of the
great warrior and divided his bones among the soldiers, to be worn
in rich reliquaries as amulets of courage. His countrymen still sing of
him as their national hero, and the Turks frighten naughty children
with his terrible name.
After Scanderbeg’s death many Albanians emigrated to Italy, either
in the suite of his son or independently. The most remarkable colony
was in Calabria, where as late as 1780 their descendants, numbering
about one hundred thousand, retained the dress, manners, and
language of their ancestors. Another colony, not so numerous, is
scattered about the Abruzzi. The last lineal descendant of the hero
was the Marquis of Sant’Angelo, who was killed at the battle of Pavia
by the hand (as Paulus Jovius says) of Francis I.
Most of the Albanians remained Christians until the middle of the
seventeenth century, when the majority conformed, outwardly at
least, to the Mohammedan religion. The popes have tried hard to
keep alive the Catholic faith among the population, and, under the
circumstances, with considerable success. Pope Clement XI., of the
(now) princely family of Albani which emigrated from Albania in the
sixteenth century, and settled at Urbino, established a purse of four
thousand scudi in 1708 for the support of three students from that
country in the Propaganda College. The Catholics there do not now
number more than ninety thousand. There are two archbishoprics,
Antivari united with Scutari, and Durazzo, and three bishoprics,
Alessio, Pulati, and Sappa. These sees are usually filled by
Franciscans, who, with a few Propagandists (with one of whom, now
bishop of Alessio, we have the honor of being acquainted), are the
only missionaries in the country. We conclude our article with a
bibliographical notice of the subject, because, as Dr. Johnson used to
say, a great part of knowledge consists in knowing where knowledge
is to be found.
The original source of information upon which all subsequent
writers, whether with or without acknowledgment, have drawn is a
work by Marino Barlezio, a priest of Scutari, who, besides being a
native of the country about which he wrote, was an almost constant
companion of Scanderbeg and an eye-witness of most of the events
which he relates. He was a scholar and penned very excellent Latin,
which greatly adds to the charm of his narrative. We give the full
title: De Vita et Moribus ac Rebus præcipuè adversus Turcas gestis
Georgii Castrioti clarissimi Epirotarum Principis, qui propter
celeberrima facinora Scanderbegus, hoc est Alexander Magnus,
cognominatus fuit. Libri xiii. It is not certain where this curious book
was first published. Some say at Rome as early as 1506, but this is
extremely doubtful; others at Frankfort in 1537 (in folio). A German
translation by Pinicianus was published in 1561 in 4to, with
woodcuts; and a French one, the language of which is quaint and
racy, by Jacques de Lavardin, in 1597. Independent biographies have
been written in Latin by an anonymous author at Rome in 1537 or
earlier, in folio; in Italian by T. M. Monardo, Venice, 1591, and almost
immediately translated into Spanish and Portuguese; in French by
Du Poncet (Paris, 1709, in 12mo), a Jesuit, who took upon himself to
refute the calumny of Machiavelli and Helvetius, that Christian
principles and practices can never develop the qualities of a perfect
soldier, a hero. Other French biographies are those of Chevilly (Paris,
1732, 2 vols. 12mo), and Camille Paganel (ibid. 1855, 1 vol. 8vo),
which is the best we have read. In English there is one by Clement
C. Moore, an American (New York, 1850), and another by Robert
Bigsby, an Englishman (London, 1866); while we have also, from the
graceful pen of Benjamin Disraeli, The Rise of Iskander, a tale
founded on Scanderbeg’s revolt against the Turks (London, 1833). A
Summarium or epitome of his life is preserved among the MSS. of
the Royal Library at Turin; and the Grand Ducal one at Weimar
treasures among its rarities a MS. parchment called The Book of
Scanderbeg, composed of three hundred and twenty-five leaves,
each of which is beautifully illustrated with figures in india-ink
representing scenes from civil and military life in the fifteenth
century. It was a present to the Albanian hero from Ferdinand of
Aragon. Two Latin poems have been published about him, one by a
German named Kökert at Lubec, 1643, and the other by a French
Jesuit, Jean de Bussières, at Lyons, 1662, in eight books; finally, one
in Italian, called La Scanderbeide, by a lady named Margherita
Sarrocchi, without date or place of publication; but it sometimes
turns up in book-sales at Rome.
Scanderbeg’s large gilt cuirass, damaskeened with designs of
Eastern pattern, is found in the Belvedere collection at Vienna. It is
supposed to have been one of his trophies captured in Anatolia.

It was a common boast of the more ambitious sultans that they would
[78]
some day feed their horses at the tomb of St. Peter.
[79]The good and brave beget the brave;
… Fierce eagles breed not harmless doves.
The family standard of the Castriots, which Scanderbeg carried in his
battles, was a black, double-headed eagle on a red field.
 THE CHURCH AND LIBERTY.

Men are governed more by their sympathies than by reason. Weak

arguments are strong enough when supported by prejudice which is
able to withstand even the most conclusive proofs. We do not
pretend to say that this is wholly wrong. Our feelings are in general
sincerer than our thoughts; spring more truly from our real selves;
are less the product of artificial culture and more of those common
principles of our nature which make the whole world akin. But since
in rational beings the feelings cannot be purely instinctive, it follows
that they are more or less modifiable by the action of the intellect,
which in turn is also subject to their influence. Prejudice, therefore,
may be either intellectual or moral, or the one and the other; the
most obstinate, however, is that which is enrooted in feeling and
springs from sympathies and antipathies; and this is usually the
character of religious prejudice. The tendency to make religion
national, which is a remarkable feature in the history of mankind,
together with the fact that states have always been founded and
peoples welded into unity by a common faith, has as a rule thrown
upon the side of religion the whole force of national prejudice,
which, though it does not touch the deep fountains of immortal life
and of the infinite, revealed by faith, is yet an immense power, more
than any other aggressive and defiant. As the Catholic Church is
non-national, it is not surprising that she should often be brought
into conflict with the spirit of nationalism.
Christ was himself opposed by this spirit; on the one side he was
attacked by the religious nationalism of the Jews, and on the other
by that of the Romans. These enemies surrounded the early church.
There was the internal struggle to free herself from the bonds of
Judaism, a purely national faith; and there was the open battle with
the Roman Empire for the liberty of the soul and her right to exist as
a Catholic and non-national religion. Heresies and schisms have
invariably been successful in proportion as they have been able to
rouse national prejudice against the universal church. To pass over
those of more ancient date, we may safely affirm that but for this
Luther’s quarrel with Tetzel would never have given birth to
Protestantism. The conflicts during the middle ages between popes
and emperors and kings, together with schisms and scandals, had
accustomed the public mind, especially in Germany and England, to
look upon the successor of St. Peter as a foreign potentate; nor was
it easy, in the state of things which then existed, to draw the line
between his spiritual and his temporal authority. He came more and
more to be considered an Italian sovereign who had usurped undue
power, and thus in Germany and England Italians grew to be both
hated and despised; and this more, probably, than kings and
parliaments helped on the cause of Protestantism.
The Catholic faith was made to appear, not as the religion of Christ,
but as popery, a foreign idolatrous superstition, which had by artful
means insinuated itself amongst the various nations of German
blood; and to throw off the yoke of Italian despotism was held to be
both political and religious disenthralment. The specific doctrines of
Luther and the other heresiarchs had merely an incidental influence.
In England, where the separation from the church was more
complete than elsewhere, there was the least doctrinal departure
from Catholic teaching; which is of itself proof how little any desire
for a so-called purer faith had to do with the movement. The appeal
to the Scriptures was popular because it was an appeal from the
pope. That the Reformation was not an intellectual revolt, at least
primarily, there is abundant evidence in the indisputable fact that the
most enlightened and learned people of that age—the Italians—
remained firm in their attachment to the old faith; and even in
Germany, which was comparatively rude and barbarous, the
cultivators of the new classical learning, which had been revived in
Italy, were for the most part repelled by the coarseness and
ignorance of the preachers of Protestantism, who in England found
no favor with men like More and Wolsey, scholars, both of them, and
patrons of letters.
As Protestantism did not spring from intellectual convictions, but
from passion and prejudice—national antagonisms, which had been
intensified by ages of conflict and strife, and which became the
potent allies of the ambition and rapacity of kings and princes—it is
but natural that Protestants, continuing the traditions of their
fathers, should still be influenced in their opinions of the Catholic
Church more by their antipathies than by reason, and that these
antipathies should invariably run with the current of national
prejudice. Hence the objections to the church which really influence
men are not religious but social. A Protestant who accepts the Bible
as the word of God, and receives in the literal sense all that is there
narrated, could not with any show of reason make difficulty about
believing the teachings of the church; nor can one who trusts to
himself alone for his creed feel great confidence that those who are
supported by the almost unanimous consent of all Christians for
fifteen hundred years, and of the great majority even down to the
present day, are less certain of salvation than himself. But when he
comes to consider the social influence of the church, he finds it less
difficult to justify his dislike of Catholic institutions; for in this
direction he is upheld most strongly by traditional prejudice. That
the church fosters ignorance and immorality is to his mind axiomatic.
He still thinks that the darkness, the scandals, and crimes of the
middle ages, which he always exaggerates, are to be ascribed to her
and not to the barbarians. The labors of the learned have long since
shown the old Protestant theory, that the church sought to keep the
people in ignorance, to be not only groundless, but the reverse to be
true; and that not less false is the charge that she encouraged
immorality, however corrupt some who have held high ecclesiastical
positions may have been. But as we have quite recently discussed
these questions,[80] we turn to the subject of the relative influence of
the church and of Protestantism upon civil liberty. Discussions of this
kind, though not new, are nevertheless full of actual interest. The
subject of social liberty profoundly influences the practical
controversies of the age, and bids fair to become of still more vital
moment in the future. The adversaries of the Catholic Church never
feel so secure as when they attack her in the name of freedom. She
is supposed to be the fatal foe of all liberty, intellectual, religious,
and social.
For the present we shall put aside the controversies concerning
liberty of thought and discussion, and confine ourselves to the
examination of the relation of the church to social freedom. And it
will be necessary, in order to institute a comparison between her
action and that of Protestantism, to go back to the first ages to
study her early efforts in behalf of human rights.
Those great battles for human liberty were fought, not by
Christianity, but by the Christian Church. The religion of Christ was
from the beginning corporate and organized; and it was through its
organization that it exerted its influence upon individuals and upon
society. To understand, therefore, the true relation of the church to
liberty, we must study her history in the past as well as in the
present. In fact, it is only in the light of the past that the present can
be understood. The clear perception of her spirit and action during
the centuries which preceded the advent of Protestantism will enable
us to see how far and in what respect the politico-religious
revolution of the sixteenth century was favorable to social freedom.
Human society, like the heavenly bodies, is guided by two forces, the
natural tendencies of which are antagonistic, but whose combined
action, when properly harmonized, produces order. Authority and
Liberty are the centripetal and centrifugal forces of the social world;
but, unlike those which govern the motions of the planets, they are
indefinitely modifiable by free human agency. To regulate these two
powers is the eternal political problem, which is never solved
because the factors of the equation are ever varying and
consequently never known. The exaggeration of the principle of
authority is tyranny; of that of liberty, anarchy; and the excess of the
one is followed by a reaction of the other, so that, whichever
preponderates, the resulting evils are substantially the same.
Tyranny is anarchical, and anarchy is tyrannical; and both are equally
destructive of authority and liberty.
Though authority and liberty, as applied to human society, are
relative terms, they presuppose the absolute, and therefore have as
their only rational basis the existence of a personal God; and hence
the social order is, in its very constitutive elements, religious. In view
of this fact it is not surprising that the state, which is the symbol of
secular society, should be drawn to usurp the functions of the
church, the symbol of the spiritual order. As a result of this tendency,
pre-christian history shows us a universal subordination of religion to
the temporal government, or, what is practically the same, the
identification of the two powers; since, where both are united, that
which regards man’s present, visible, and urgent wants will always
preponderate.
The direct consequence of this was the destruction of liberty;
indirectly it also undermined authority. The state was absolute, and
under the most favorable circumstances, as in the Græco-Roman
civilization, recognized the rights of the citizen, but not those of
man; and even the citizen had rights only in so far as the state saw
fit to grant them. The logical development of the absorption of all
power by the state may be seen in imperial Rome, in which the ruler
was at once emperor, supreme pontiff, and God.
When the Christian, though willing to obey Cæsar in temporal
matters, reserved to himself a whole world upon which he would
permit no human authority to trespass, he asserted, together with
the supremacy of his spiritual nature, the principle to which modern
nations owe their liberties. It would indeed be difficult to exaggerate
the influence of this assertion of the sovereign rights of the
individual conscience. It contains the principles of all rights and the
essential elements of progress and civilization; it is the necessary
preamble to every declaration of human liberties; the logical
justification of all resistance to tyranny, and of every reaction against
brute force and consecrated wrong. It is the impregnable stronghold
of freedom, without which the sentiment of personal independence
which the barbarians brought with them into European life would
have been powerless to found free institutions. That sentiment was
as strong in the North American Indians; in the Tartar and Turkish
hordes which swept down from the table-lands of Asia upon fairer
and more fertile regions; and yet with them it only subserved the
cause of despotism. It is, indeed, inherent in human nature. To be
self-conscious is to wish to be free and to take delight in the
possession of liberty. This feeling finds a sanctuary in the heart of
every boy who roams the forest, or plunges through the stream, or
beholds the eagle cleave the blue heavens. It was as active in the
breasts of the early Greeks and Romans as in the barbarians who
rushed headlong upon a falling empire. The love of liberty was, in
fact, with them a sublime passion, and yet they were unable to
found free institutions because the state, absorbing the whole man,
made itself absolute.
They lacked, moreover, that of which the barbarians were also
deprived—the knowledge of the worth and dignity of human nature.
Man, as man, was not honored; to have any rights did not come of
our common nature, but of the accident of citizenship. Slavery was
consecrated as being not only just but necessary; and the slave was
outside the pale of the law. Woman was degraded and infant life
was not held sacred. In nothing is the contrast between modern and
ancient civilizations more striking than in their manner of regarding
human life. With us the life of the unborn child is under the
protection of conscience, of public opinion, and of the law equally
with that of the highest and noblest. Its value to the state, to
society, to the world, is not considered; we think of it only as a
creature of God, endowed by him with rights which men may not
violate. But this doctrine is unknown to paganism. In Rome the
father was free either to bring up his child or to murder it; even the
laws of Romulus grant him this privilege, with the nominal restriction
of obtaining the consent of the nearest of kin; but under the empire
his right to kill his newly-born infant was fully recognized. The
abandonment of children by their parents was a universal custom,
and one of which the Emperor Augustus approved in the case of the
infant of his niece Julia. If child-murder was not a crime, abortion, of
course, was no offence at all, and was universally practised,
especially among the rich. The contempt in which human life was
held is seen also in the public games—in which hundreds of men
were made to butcher one another merely for the amusement of the
spectators—as well as in the power of life and death of the master
over his slave.
It has been maintained quite recently that those who gave their
approval and lent the countenance of their presence to these
inhumanities were not therefore cruel; that, on the contrary, many of
them were kind-hearted and benevolent; but this, if we grant it,
makes our argument all the stronger, since it proves that the system
was more vicious than the men. A social state which does not
respect life is incompatible with liberty. It would be vain to seek for
the origin of our free institutions in any supposed peculiarities of our
barbarous ancestors. Nothing short of a radical revolution of thought
as to what man is could have made civil liberty possible. It was
necessary to re-endow the individual with absolute and inviolable
rights in the presence of the state. Man had to be taught that he is
more than the state; that to be man is godlike, to be a citizen is
human; but this he could not learn so long as he remained helplessly
under the absolute power of the state; nor could he, with the
conviction that the state is the highest and that he exists for it, make
any effort to break the bonds of his servitude. Before this could be
possible he had to be received into a society distinct from, and
independent of, the state; he had to be made fully conscious that he
is a child of God, in whose sight slaves have equal rights with kings.
It was necessary to bring out man’s personal destiny in strong
contrast to the pagan view, which took in only his social mission,
and this narrowly and imperfectly.
This is what the Christian religion did: it created a personal self-
consciousness which made heroes of the commonest natures. The
Roman died for his country; the Christian died for God and for his
own soul’s sake. He was not led to brave death by the majesty of
the city, of the empire, or by the memory of the victories which had
borne his country’s arms in triumph through the world, but by his
own individual faith and duty as a man with a personal and immortal
destiny. When the Christian appealed from emperors and senates
and armies, from the power and force of the whole world, to God, it
was the single human soul asserting itself as something above and
beyond this visible universe. Never before had the eternal and the
infinite come so near to man; never before had he so felt his own
immortal strength. He was lifted up into the heaven of heavens,
stood face to face with the everlasting verities of God, became a
dweller in the world that is, and the garments of space and time fell
from his new-born soul. He was free; strong in the liberty with which
Christ had clothed him, he defied all tyrannies. “As we have not
placed our hope,” said Justin to the Emperor Antoninus, “on things
which are seen, we fear not those who take away our lives; death
being, moreover, unavoidable.” The pagan Roman knew, indeed,
how to die; but his death, though full of grandeur and dignity, was
sombre and hopeless; he died as the victim of fate. To the Christian
death came as the messenger of life; he died as one who is certain
of eternity, as one whose soul is free and belongs to himself and
God. This sense of a personal destiny which is eternal, of infinite
responsibility, gave to the individual a strength and independence of
character for which we will seek in vain among the religions of
paganism. It is a feeling wholly distinct from the barbarian’s dislike
of restraint. The love of wild and adventurous life neither fits men
for the enjoyment of liberty nor predisposes them to grant it to
others.
The more we study the history of Christian nations, the more
profound is our conviction that without their religion they could
never have won their liberties, which even now without this divine
support could not be maintained. It is to our religion that we are
indebted for the creation of popular free speech. Before Christ gave
the divine commission to the apostles, philosophers had discoursed
to their chosen disciples, and orators had declaimed to citizens, on
the interests of the state; but no one had spoken to the people as
moral beings with duties and responsibilities which lift them into the
world of the infinite and eternal. There were priesthoods, but they
were mute before the people, intent upon hiding from them all
knowledge of their mysteries. Religious eloquence did not exist; it
first received a voice on the shores of the Lake of Genesareth and on
the hills of Judea, in the preaching of Jesus, who remains for ever its
highest exponent, speaking as one who had authority with godlike
liberty on whatever most nearly touches the dearest interests of
men; speaking chiefly to the people, bringing back to their minds the
long-forgotten truths which prove them the royal race of God. The
preaching of God’s word with the liberty of Heaven, which no earthly
authority might lessen, became the great school of the human race;
it was the first popular teaching, and like an electric thrill it ran
through the earth. It belongs exclusively to the religion of Christ.
Mahomet, who sought to borrow it, was able to catch only its feeble
echo. This free Christian public speech is unlike all other oratory; it
possesses an incommunicable characteristic, through which it has
exercised the most beneficent influence upon the destinies of
mankind. It is essentially spiritual, lifts the soul above the flesh, and
creates new ideals of life; inspiring contempt for whatever is low and
passing, it begets enthusiasm for the divine and eternal. It is a voice
whose soul-thrill is love, the boundless love of God and of men, who
are the children of this love, and therefore brothers. This voice
cannot be bought, it cannot be silenced. Currit verbum, said St. Paul,
and again from his prison-cell: “But the word of God is not fettered.”
On innumerable lips it is born ever anew; and always and
everywhere it is a protest against the brutality of power, an appeal in
the name of God, our Father in heaven, in behalf of the poor, the
oppressed, the disinherited of humanity. Men may still be tyrants,
may still crush the weak and sacrifice truth and justice to their lustful
appetites; but the voice of God, threatening, commanding, rebuking,
shall be silent nevermore.
Festus will tremble before Paul; at the bidding of Ambrose
Theodosius will repent; and before Hildebrand the brutal Henry will
bow his head. At the sound of this voice all Europe shall rouse itself,
shall rush, impelled by some divine instinct, into the heart of Asia, to
strike the mighty power which threatened to blight the budding hope
of the world. If we would understand the relations of the church to
liberty, we must consider the influence of this free speech, which,
without asking the permission of king or people, impelled by a divine
necessity, made itself heard of the whole earth. Over the door of his
Academy Plato had inscribed: “None but geometers enter here”;
over the portals of the church was written the word of Christ: “Come
to me, all ye who labor and are heavy laden.” “All you,” exclaimed St.
Augustine, “who labor, who dig the earth, who fish in the sea, who
carry burdens, or slowly and painfully construct the barks in which
your brothers will dare the waves—all enter here, and I will explain
to you not only the γνῶθι σεαυτόν of Socrates, but the most hidden
of mysteries—the Trinity.” This new eloquence was as large as the
human race; it was for all, and first of all for the poor and the
oppressed. It was not artistic, in the technical meaning; it did not
captivate the senses; it was not polished. There was no showy
marshalling of words and phrases, no sweet and varied modulation
of voice, no graceful and commanding gesture. Around the altar
were gathered the slave, the beggar, the halt, and the blind—the
oppressed and suffering race of men. If with them were found the
rich and high-born, they were there as brothers—their wealth and
noble birth entered not into the church of Christ. Here there was
neither freeman nor slave—all were one. Thus in every Christian
assembly was typed the humanity which was to be when all men
would be brothers and free. To this new race the apostle of Christ
spoke: “My brothers,” he said, or “My children”; and though all
history and all society shrieked out against him, his hearers felt and
knew that his words were God’s truth. The heart is not deceived in
love. “I seek not yours,” he said, “but you; for God is my witness
how I long after you all in the heart of Jesus Christ.… I could wish
that myself were accursed, if only my brethren be saved.” And then,
with the liberty which love alone can inspire, he threatened,
rebuked, implored, laid bare the hidden wounds of the soul, nor
feared to become an enemy for speaking the truth. To the great and
rich he spoke in the plainest and strongest manner, reminding them
of their duties, denouncing their indifference, their cruelty, their
injustice; and then, in words soft as oil, he breathed hope and
courage into the hearts of those who suffer, showing them beyond
this short and delusive life the certain reward of their struggles and
sorrows. He taught them that the soul is the highest, that purity is
the best, that only the clean of heart see God; that man’s chief
worth lies in that which is common to all, derived from God and for
him created. Human life was perishing, wastefully poured through
the senses on every carnal thing. No love of beauty or truth or
justice was left. The mind was darkened, the heart was paralyzed.
The great, strong human passions that bore the people of Rome in
triumph through the earth were dead; everywhere, in religion, in art,
in manners, was the deadly blight of materialism; a kind of delirium
hurried all men into animal indulgences fatal alike to soul and body.
To a race thus glued to the earth by carnal appetites came the voice
of the apostle, preaching Christ and him crucified; telling of the
divine love that had bowed the heavens and brought down to men
God’s own Son to suffer, to labor, to die for them. He was poor, he
was meek and humble, he fasted, he prayed; he comforted the
sorrowful, gave hope to the despairing; he offered up his life for
men. Such as he was those who believe in him must be. To serve
the lusts of the flesh, to be heartless, to be cruel, to be unjust, is to
have no part with him. The greed of gold and of pleasure had
reduced the masses of men to slavery and beggary; those who
would follow God’s Son in the perfect way were to sell what they
had, to give to the poor. The whole race of men was fallen, sunk in
sin; the disciples of Christ were bidden to separate themselves from
a world which had denied God, that, having received faith, hope,
and love through union with him, they might bring to the dying
peoples a new life.
The Christian religion turned the mind’s eye from the contemplation
of beauty of form to the inner life of the soul; from thoughts of
power and success to principles of right and justice. All the forces of
society had been brought together to develop in its highest potency
the passion of patriotism, which, bending to its purpose all the
powers of individual life, had created mighty states, embellished
them with art, crowned them with victory, made them eternal in
literature that cannot die; but on the altar of all this glory man had
been sacrificed. Patriotism had failed, hopelessly failed, to satisfy the
unutterable longings of an immortal race. It was based upon false
principles and perverted instincts. Man’s end is not more fulfilled in
citizenship in a great and prosperous state than in the possession of
vast wealth. The religion of patriotism was a low and material creed
without eternal verities upon which to rest. Power was its divinity,
and it was therefore without mercy; success was its justification, and
it consequently trampled upon right. It is not surprising that such
principles should have created states whose chief business was to
prey upon the human race, and which, when conquest was no
longer possible, were brought to ruin by the viciousness of their
essential constitutions. In fact, patriotism, as understood by the pre-
christian states, was a denial of the principles out of which the
common law of Christendom has grown. It placed the interests of
the nation above those of the race, and thereby justified all
inhumanity if only it tended to the particular good of the state.
In contradiction of this unjust and narrow spirit, the Christian
preacher declared that man’s first duty is to God, as his first aim
should be to seek God’s kingdom by purifying and developing his
own moral nature. He declared that man is more than the state, as
God is more than the world; inspiring in another form those views of
the paramount worth of the individual soul without which there
could be no successful reaction against the slavery and degradation
of paganism. “The world,” said Tertullian, “is the common country
and republic of all men.”
These principles gradually worked their way, through “the
foolishness of preaching,” into the minds and hearts of the masses
and became the leaven of a new society. Let us examine their action
more specially. In the church the brotherhood of the race was from
the earliest day not only taught but recognized as a fact. “There is
neither Jew nor Greek,” said St. Paul, “neither bond nor free, neither
male nor female; for you are all one in Christ Jesus.” This doctrine is
stated in various places in the New Testament with such emphasis as
to leave no doubt of its true meaning. It is equally certain, however,
that the apostles did not proclaim the emancipation of the slaves.
“Let those who are servants under the yoke,” said the same apostle
who declared that in Christ there was neither bond nor free, “count
their masters worthy of all honor, lest the name of the Lord and his
doctrines be blasphemed.”
It was not the spirit of the Christian faith to encourage visionary
schemes or to awaken wild dreams of liberty; but rather to subdue
and chasten the heart, to make men content to bear worthily the ills
of life by giving to suffering a meaning and a blessing.
The misery of the pagan slave was extreme, but it was also
hopeless. He believed himself the victim of relentless fate, from
whose power death was the only deliverance, and he therefore
rushed wildly into all excess, giving little thought to whether he
should live to see the morrow. Suffering for him was without
meaning—a remediless evil, a blind punishment inflicted by
remorseless destiny. For this reason also his wretchedness excited
no pity. Even as late as the time of St. Ambrose the pagans were
accustomed to say: “We care not to give to people whom the gods
must have cursed, since they have left them in sorrow and want.”
But with the preaching of Christ, and him crucified, came the divine
doctrine of expiatory suffering—of suffering that purifies,
regenerates, ennobles, begets the unselfish temper and the heroic
mood. When the Christian suffered he was but filling up the measure
of the sufferings of Christ. The slave, laboring for his master, was not
seeking to please men; he was “the servant of Christ, doing the will
of God from the heart”; “knowing that whatsoever good any man
shall do, the same shall he receive from the Lord, whether he be
bond or free.” Masters in turn were taught to treat their slaves kindly
and gently, even as brothers; “knowing that the Lord both of them
and of you is in heaven, and with him there is no respect of
persons.”
Thus, without attempting to destroy slavery by schemes that must
have been premature, the Christian religion changed its nature by
diffusing correct notions concerning the mutual rights and duties
implied in the relations of master and slave. The slave as a brother
in Christ is separated by a whole world from the slave who is a tool
or chattel. Who can read St. Paul’s Epistle to Philemon, written in
behalf of the fugitive slave Onesimus, without perceiving the radical
revolution which Christianity was destined to make in regard to
slavery? “I beseech thee for my son, Onesimus: … receive him as my
own heart; no longer as a slave, but as a most dear brother. If he
hath wronged thee in anything, or is in thy debt, put it to my
account.”
This is after all but the application of the teaching of Christ: I was
hungry, I was thirsty, I was sick, I was a captive, and ye fed me, ye
gave me to drink, ye visited me; for inasmuch as ye have done this
for the least of my brethren, ye have done it for me. In every
suffering and wronged human being there is the Christ to be
honored, to be loved, to be served. Whosoever refuses to take part
in this ministry places himself outside the kingdom of God.
Slavery, from the Christian point of view, is but one of the thousand
ills entailed upon the human race by the transgression of Adam; it is
enrooted, not in nature, but in sin; and as Christ died to destroy sin,
his religion must tend to diminish and gradually abolish its moral
results. The freedom of all men in Christ which the great apostle so
boldly proclaims must in time find its counterpart in the equality of
all men before the law. Indeed, the admission of the slave into the
Christian brotherhood logically implied the abolition of slavery. It so
raised the individual by giving him the knowledge of his true dignity,
and so softened the master’s treatment, that the moral elevation of
the whole class was the inevitable result. In this way the church
made the slave worthy to be free, and from this to liberty there is
but a step. “We teach the slaves,” said Origen, “how they may beget
in themselves a noble spirit, and so become free”; and it need not
surprise us, therefore, when Lactantius testifies that among
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